Sign
Language with People who are Deaf-Blind:Suggestions for Tactile and Visual
Modifications.

By Susie Morgan.

Technical Assistance Specialist National Technical Assistance Consortium
for Children and Young Adults Who Are Deaf-Blind.

Communicating with individuals who are deaf-blind is a unique experience.
The language, mode, style, speed, and aids and devices used to facilitate
communication are different from person to person. If you are interpreting
for an individual who is deaf-blind you will need to know what adaptations
will be appropriate and what additional environmental concerns you
should be aware of. This article provides helpful hints about
techniques that will enhance your comfort and ease your concerns when working
with deaf-blind people.

The information in this article will be useful to a variety of communication
partners such as interpreters, support service providers, intervenors,
teachers, companions, and anyone else who is facilitating communication
with an individual who is deaf-blind. It assumes that you are already
fluent in the consumer's preferred sign language system and knowledgeable
of cultural and linguistic differences that may affect your interaction.
Due to the various etiologies, modes of communication, and cultural
and linguistic differences among individuals in this population, some of
these suggestions may be applicable to one consumer but not to another.
It is imperative to ask the consumer his or her preferences on how the
message should be conveyed and what additional auditory and visual information
should be detailed.

Expressive Communication

Appearance/Attire

Wear clothes that provide contrast for your hands. Consider the
following guidelines when selecting clothing:

Many people wear a smock over regular clothes and keep one in their office
or car for accessibility.

Wear plain jewelry that is not visually or tactually distracting. Avoid
rings, bracelets and necklaces that may interrupt the flow of communication.
Avoid sparkling or dangling earrings as they can reflect light and cause
interference.

Fingernails should be short, neat, and filed smoothly. Rough edges
can be irritating. A neutral color of polish may be worn, but avoid
bright reds, dark colors, French manicures, or other frills.

Due to close sharing of personal space, you need to ensure good personal
hygiene.

Avoid perfumes and scented hand lotions.

Wash hands often or use an antibacterial lotion when moving from consumer
to consumer to reduce the risk of "germ sharing."

Use non-oily, unscented lotion on a regular basis to avoid dry or rough
skin that may cause distractions when communicating for extended periods
of time.

Distance & Seating

The distance between you and the consumer will vary from situation to
situation depending on the consumer's mode of reception. The consumer
may use visual reception while you are signing in a reduced area sitting
at a specified distance away. This situation may occur if an individual
has peripheral vision loss and relies on central vision (also known as
"tunnel vision"). Tracking is another possible visual modification. Tracking
allows the consumer to keep your hands in a restricted signing space by
grasping either your forearms or wrists.

When communicating tactually, close seating is necessary. There
are a variety of seating arraignments. For example, when communicating
with a one-handed tactile receiver, you and the consumer may sit side-by-side
or at the corner of a table so that the consumer can rest his or her elbow.
However, if the consumer is a two-handed tactile receiver, a comfortable
position is to sit facing each other with legs alternating. Women
may want to avoid short or straight skirts as they
are problematic for this configuration. Slacks or wider, full skirts
allow more flexibility.

For both communicators, it is helpful if the levels of the chair seats
compensate for the height differences of the signers. For comfort and in
order to avoid fatigue, your bodies and signing spaces should be at similar
levels.

Chairs with arm rests and back support are helpful. An additional
chair may be placed next to each communicator. The back of the chair can
then be used to provide support for either the signing or the receiving
hand.

Signing Space

Be sure that both you and the consumer are comfortable with the personal
and signing space established. When communicating with individuals who
rely on residual vision (e.g., tunnel vision), you need to be cognizant
of the location of your hands in the signing space. They should be held
slightly below your face in front of your clothing to allow for color contrast.
When
communicating tactually, it is helpful to move the general signing
space down to the chest for postural ease.

During tactile signing, you must be comfortable using signs that come
in contact with the body. The location of signs and consistency of
placement are crucial for clear communication. Adaptations such as
ducking your head to accommodate for the sign for "father" or "mother,"
for example, will cause confusion because the receiver determines gender
by the height of the signer. In some cases, however, to be less obtrusive,
simple modifications may be made to certain signs by either lowering or
raising the hand slightly from its original contact position. For
example, "home" which touches the face or "body/mine" which touches the
chest.

Hand Positioning

The use of one-hand versus two-hand tactile reception of communication
varies depending upon the preference of the consumer. Allow the consumer
to place his or her hand(s) where he or she is comfortable and to follow
your hands freely. Do not "squeeze" or pull the consumer's hand(s)
toward you.

Conveying the Message

Whether communicating tactually or visually with someone with reduced
vision, you must identify who is talking and where the speaker is located.
If it is known, use the sign name of the individual and point in the direction
where they are seated. If a sign name is unknown and it is an inappropriate
time to request one from the speaker, one can be created between the interpreter
and consumer to save time and establish consistency.

Before the activity, if at all possible, discuss the consumer's preferred
mode, style, and speed of communication. In order to convey the tone
and manner in an accurate way, attempt to follow the speed and fluidity
of the speaker while meeting the speed of reception and processing time
of the consumer. To ensure clarity, however, fingerspelling and number
production should be
produced at a slower pace for both visual or tactile receivers.

One of the essential components to communicating visually is facial
expression. If a consumer has tunnel vision, low vision, or complete blindness,
many or all of these expressions can be lost. It is imperative that
you become adept at adding facial expressions using hand and body language.
Signs can be added to describe the apparent emotion of the speaker.
For example, if a person is laughing, the signs for "smiling," "laughing"
or "hysterically laughing" can all be added to aid in conveying the speaker's
expression. If the speaker is angry, you may add the signs for "raised
eyebrows," "frowning," or "mouth turned down."

When relaying facial expression, it is not necessary to constantly repeat
the same expression but do convey any change in facial expression. If a
person is upset, frowning, has tears in his eyes and then begins to cry,
pulls out a handkerchief and blows his nose, all that information should
be relayed. However, if a person is frowning and maintains this expression
throughout the
conversation, it does not need to be repeated more often than at the
beginning and end of the speaker's monologue.

Use body language to convey the message (spoken language or body language)
of the speaker whenever possible. For example, if the speaker shakes
his or her head dramatically, bends over in laughter, and grimaces in disagreement,
the interpreter should relay this information by replacing head movement
with hand movement and arm movement to replace upper torso movement.

Tactile Adaptations

When using signs that require and provide information from two hands
("highway," "garage," "meeting people," "total communication"), both of
your hands should come in contact with the consumer's hand. This
can be done either through a one-handed or two-handed tactile position.
A skilled one-handed tactile receiver may not need additional contact for
clarity. Use your judgment about when to move to a two-handed tactile
approach in order to convey the message most accurately.

Some confusion or awkwardness in positioning can occur with various
signs. For clarity, additional information may need to be added or
a slight variation of the sign may need to be employed. Because
a consumer may not visually be able to discriminate between "understand"
and "don't understand" it is imperative to elaborate the interpretation
to include the sign for "yes,"
"no," or "not" or provide head movement in the hand. Many signs
are similar and can be easily misinterpreted by the consumer. Simple
additions can provide clarity. Consider the following examples:

The word "gun" may be confused with the number "21." To avoid confusion,
fingerspell "g-u-n" and add the sign "number" before "21."

Due to body positioning the traditional sign for "dog" can be awkward.
It is helpful to fingerspell "d-o-g" or use a version of a finger snap

To ensure clarity when fingerspelling, add the context before fingerspelling
a word. For example, "city, c-h-i-c-a-g-o," "name, k-a-r-e-n," "time,
10:30."

The print-on-palm method, instead of the tactile use of numbers, is sometimes
preferred when conveying numbers and/or money. Use your index finger in
the palm of the consumer's hand. The letters should be in capitals (except
for "I"), block format. Stay in the palm area. Do not print down
the hand toward the fingers.

Be very clear about where a question is directed. Depending on
the context of the question, a different sign may be employed. If
the speaker is directing a question to the entire audience you could use
the sign for "question/question mark" in a circular manner. If the
question is directed to an individual, you should sign in the direction
of the individual, adding the sign name or
description of the person in question.

At times, it can be difficult to discriminate between a question and
a statement. You may wish to add a question mark or question indicator
after the statement to help avoid possible misunderstandings.

Describing the Full Environment

When entering a new environment, be sure to explain the surroundings.
If you have entered a restaurant and there is a long waiting line and the
customers look unhappy, relay this information. Describe the color
of the walls and things in the room, decorative style, lighting, seating,
table arrangement, and so on. Inform the consumer where things are located
in relation to
his or her body. For example, a chair to the immediate left, handouts
on the right of the table, a pitcher of water directly in front. Use of
the "clock" or "compass" concept to describe items inthe environment may
be helpful. You can say that the glass of water is at 12:00 o'clock
or the brailled handouts are on the east end of the table.

Describe items of importance or items that draw attention such as a
woman wearing a violet suit, a video camera in the corner recording the
meeting, people who appear to look uncomfortable, and so on. Additional
visual information should be shared such as the news that a person in the
meeting has fallen asleep, a couple is fighting across the street, or a
person sitting across the table keeps sneezing. To the best of your
ability, try to relay what is happening in the environment without allowing
your personal opinion to influence the information that is being communicated.
Describe how many people are in the environment and ask the consumer if
he or she would like to know, by name, who is there.

When you are describing an event, it may be helpful to move from a one-handed
tactile approach to a two-handed tactile approach to allow for a fuller
description. For example, if you are describing Michael Jordan getting
ready to shoot a basket, it helps to add his facial expression, or that
he is sweating, or his legs are in the air, and so on.

Receptive Communication Issues

Environmental Concerns

Numerous environmental factors can hinder the flow of communication.
These include the following:

Inadequate lighting that causes dimness or shadows. Additional floor
lamps may be helpful. When establishing seating arrangements, consider
where shadows will fall.

Distracting overhead lighting such as light from overhead projectors and
florescent lights.

Glare from outside. Close the blinds or turn your seats in a different
direction so that the consumer's back faces the lighting source.

Confusing background. It is helpful to have a solid, black or dark background
behind you.

This backdrop enhances visual reception for the consumer and can also provide
assistance to a

Team Interpreter who is feeding information and/or interpreting sign-to-voice.
(A Team Interpreter is someone who works as a support partner to the interpreter
who is currently communicating with the consumer. The Team Interpreter
provides either visual and/or auditory information that may have been missed.)

Consumer Feedback

If you are working with the same consumer over a long period of time,
establish a system that works for both of you. Certain tactile feedback
provided by the consumer can aid the flow of communication. Examples include
the following:

"Keep going." The consumer taps one or more fingers on top of your hand.

"No." The consumer's two fingers ("no" sign) will tap on top of your hand.

"Ha ha." The consumer may put two fingers similar to the sign for "no"
on top of the your hand or may sign "ha ha" under your hand.

Facial expressions. These vary from consumer to consumer; however, you
can clarify which expressions portray specific feelings. A frown may mean
"confusion," raised eyebrows may mean "thinking/processing," head nodding
may mean "I'm following/understanding," and so on.

Team Interpreting/Duration of Interpreting

Due to the additional weight and unusual positioning used while interpreting
tactually or communicating with visual modifications, you will want to
work in partnership with someone else. To avoid fatigue or undue stress,
you should switch often with your partner, approximately every 15 to 20
minutes. Try to coordinate this exchange with a natural pause to avoid
interrupting the flow of communication.

Cumulative motion injuries can occur whenever there is repetition and
extensive use of the hands. In addition, for consumers who receive information
through tracking method or tactile sign language, taking breaks to rest
and stretch the arm of the receiving hand may be necessary. Some
consumers prefer to receive information in their nondominant hand to provide
relief to
their dominant hand. If you can perform sign communication with
your nondominant hand at the same level as with your dominant hand, offering
to switch hands may be greatly appreciated by the consumer.

Additional Information

Do not consistently interrupt the dialogue to check for clarity.
Instead, it is helpful to set up a system with the consumer beforehand.
For example, at the start you may say, "If I am not clear, please stop
me." It is then the consumer's responsibility to ask for clarification.
Continually asking, "Do you understand me?" or "Am I clear?" can be disrupting
and insulting.

Due to the ambulatory issues of individuals who are deaf-blind, you
may be asked to "sight guide" a consumer. It is helpful to become familiar
with basic sighted guide techniques.

Discuss with the consumer what symbol or sign to use in an emergency.
Some consumers and interpreters are familiar with the process of
printing a large "X" across the back of the consumer. An "X" is a clear
indicator that an emergency situation has occurred, sudden movement is
necessary, and explanations will follow. However, even though this symbol
is somewhat
universal, not all consumers are familiar with this method.

Remember to rely on other communication partners in the environment
for additional visual activity or information that may have been missed.
Teamwork is essential!

Be honest about how the environment is affecting you. A consumer
can tell if you are in a hurry, frustrated, mad, lazy, tired, scared, nervous,
sloppy, don't care, and so on. If you think it will affect your work,
discuss your mood with the consumer. Remember to take breaks and
stretch.

Finally, when in doubt ASK!

Special thanks and appreciation goes to M.J. Shahen, Kathy Zarate, Maricar
Marquez, Stacey Sullivan, and Rich McGann. Without their expertise, experience,
and support, this article could not have been written.